A Retrospective Study on the Potentially Fatal Asthma.
- Author:
Jong Myung LEE
1
;
Youn Keun HWANG
;
Jong Soo YUN
;
Cheon Il KANG
;
Young Ik SEO
;
Nung Soo KIM
;
Seong Mo KOO
;
Bong Kee CHO
;
Young Mo KANG
;
Choong Ki LEE
Author Information
1. Department of Internal Medicine, School of Medicine, Kyungpook National University, Taegu, Korea.
- Publication Type:Original Article
- Keywords:
Potentially fatal asthma;
Clinical and laboratory profiles
- MeSH:
Age Distribution;
Air Pollution;
Airway Obstruction;
Anti-Inflammatory Agents, Non-Steroidal;
Asthma*;
Blood Gas Analysis;
Carbon Dioxide;
Consciousness;
Daegu;
Eating;
Emergency Service, Hospital;
Female;
Gyeongsangbuk-do;
Hospitalization;
Humans;
Incidence;
Male;
Potassium;
Precipitating Factors;
Pyroglyphidae;
Reference Values;
Research Personnel;
Respiration, Artificial;
Respiratory Tract Infections;
Retrospective Studies*;
Risk Factors;
Seasons
- From:Korean Journal of Medicine
1997;52(1):7-14
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: A number of investigators have examined the possible pathophysiological mechanisms in patients who died from asthma, but the reasons for the increased incidence of death in patients with asthma are largely unknown. To elucidate the risk factors and possible causes of fatal asthma, we reviewed the clinical data of patients with potentially fatal asthma(PFA). METHODS: We retrospectively studied the clinical and laboratory profiles of 35 PFA patients(43 episodes) who had been admitted at the Kyungpook University Hospital and Taegu Fatima Hospital in recent 5 years(1989. 7-1994. 6). Our criteria of PFA were defined as either respiratory arrest or an arterial carbon dioxide tension(PaCO2) greater than 50 mmHg or an altered state of consciousness, due to acute asthma. RESULTS: 1) Twenty four patients with PFA were female and 11 male. At the time of PFA episode, age distribution was between 16-65 year (42% between 36-49). 2) Seasonal distribution was 13 episodes between March and May, 13 June and August, 6 September and November, 11 December and February. 3) Previous hospitalization history due to asthmatic attack was noted in 81 percent, and 75 percent were relatively compliant to their therapy. 5) At visiting emergency room, 81 percent satisfied the criteria of PFA, whereas 19 percent during hospitalizatoin. 77 percent required mechanical ventilation, and 52 percent of them within 30 minutes after visiting. 6) Initial arterial blood gas analysis at emergency room showed marked hypercapnia(75 +/- 29 mmHg), hypoxemia(50 +/- mmHg) and acidosis(pH 7.14 +/- 0.15). Serum potassium levels were within normal ranges in 75 percent. 7) All, except one, showed no significant cardiac arrthymias. 8) Possible precipitating factors leading to PFA were respiratory tract infection in 31 episodes, ingestion of NSAIDs in 2, emotional upsets in 2, irritant air pollutions in 2, withdrawal of anti-asthma drugs in 1, and unknown causes in 5. 9) Nine of 16 patients were atopic, and majority of them showed positive reaction to Dermatophagoides antigen. CONCLUSIONS: These results may suggest that PFA is mainly due to airway obstruction, and upper respiratory infection is an important precipitating factor leading to PFA. It is necessary to establish an appropriate plan for preventing PFA and related deaths.
